Salivary Fistula After Osteosynthesis of the Mandibular Condyle

Surgical management of condylar process fractures is associated with postoperative complications, the most common being transient facial nerve palsy. Less frequent but noteworthy is the development of salivary fistulas, which, although rare, constitute a clinically relevant condition. This research aimed to investigate factors impacting salivary fistula formation and treatment in patients surgically treated for mandibular condylar process fracture. This study included 395 patients who underwent open rigid internal fixation. Salivary fistula occurred in 5.8% of those treated. Multiple factors were assessed as potential contributors to post-operative fistula formation, but only gender demonstrated a statistically significant association as an independent risk factor. The longer the surgical procedure, the sooner a fistula will appear in the postoperative follow-up period. Moderately elevated white blood cell and C-reactive protein levels were associated with faster resolution of salivary fistula. Treatment duration was longer for patients with a low body mass index. The most effective treatment method was disinfecting the fistula, applying a pressure dressing, and adhering to a tasteless diet; both chemical cauterization and plastic surgery proved to be less effective. When a fistula occurs, it can be successfully resolved in a relatively short period of time: median 10 days; in most cases, conservative methods are sufficient.

As this is a pioneering study, further research is necessary to validate the results.